How often do health insurers say no to patients? (2023)

(www.propublica.org)

94 points lentoutcry | 2 comments | 06 Sep 25 20:01 UTC | HN request time: 0.592s | source

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wtbdbrrr ◴[06 Sep 25 21:18 UTC] No.45152929[source]▶

All the time is not a number but in Germany it's common that your legitimate insurance claim gets rejected at first and then you appeal once or twice and do the paperwork and document the proof again, citing all terms & conditions that apply and you get what you are owed or you get a lawyer to do the whole thing again and get what you are owed then.

"Arbeitsbeschaffungsmassnahmen" ( German for "employment creation scheme" ) in an industry where there is not enough actual work for--and or to justify the--number of employees. One of the more useful Ponzi schemes; if you are not a real capitalist, that is. Because if you are, then this shit is just fugly drag.

replies(1): >>45153689 #

1. braabe ◴[06 Sep 25 22:59 UTC] No.45153689[source]▶

>>45152929 #

I have had this experience, but not with healthcare insurers (in Germany). I cannot remember the last time I had to contact them - the last two times they contacted me, was to explain to me, that they have expanded their preventive care offerings and they recommend I go and get them.

Blanket rejections are an extremly efficient measure from the perspective of an entity when the consumer has nowhere else to go and you don't care about ethics. Just tell them no and many people will just give up. If they appeal, you can invest the work to fob them off properly or just pay and not deal with the hassle. I can barely tell the difference with the many public healthcare insurers in germany - if my insurer were to try this nonsense, I would be gone the next month. Universities, some agencies and especially the god-damned GEZ on the other hand...

What frustrates me more, is that it often turns into a class indicator: Do you know how to word your letters or to handle yourself in a way that indicates, that it will be more annoying to not-deal-with-you than to deal-with-you? And if you don't: Do you have a access (network/money) to someone who does?

replies(1): >>45161012 #

2. wtbdbrrr ◴[07 Sep 25 18:45 UTC] No.45161012[source]▶

>>45153689 (TP) #

> is that it often turns into a class indicator

Oh, man. One could rant for hours about this. You are absolutely right. But in the end it's not really a class indicator because info about this particular and similar schemes could theoretically be packed into a weekend long workshop. In any small company or big factory, and definitely in schools as early as grade 10.

But it's a matter of character and you have to be damn lucky if you get a teacher who cares that much. Even neighbors will more often than not, NOT enlighten "the less fortunate" about stuff like this. It's pathetic.

But that's why this cascade works so well to keep almost all of the "more fortunate" under perfect societal control by which I don't mean some mythological conspiracy but "Steuerungsmechanismen" (some dude who got out of some cult beautifully explained this but I forgot both his name and the title of the book), keeping almost all of them in line, mostly silent, and alienated from the inter-generational usefulness of critical thinking.

And there is no irony in all this. Too many peoples mindsets never left the modern dark ages. One can only raise a brow and chuckle at all this.

It's a class indicator for sure, but, in my opinion, not class in the sense of hierarchies but of intellectual style, niveau. These tactics are low, like punching drugs.

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